Individual
SHAWNA RUTH GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 SERENITY LN, COBURG, OR 97408-9350
(541) 284-5724
Mailing address
1 SERENITY LN, COBURG, OR 97408-9350
(541) 284-5724
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/15/2018
Last updated
09/06/2022
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